温灸盒温灸治疗糖尿病神经源性膀胱的临床疗效观察

发布时间：2018-03-04 06:22

本文选题：温灸　切入点：糖尿病神经源性膀胱　出处：《新疆医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:评价温灸盒温灸治疗糖尿病神经源性膀胱(肾气不足、肾阳亏虚型)的临床疗效及安全性,为其临床应用提供具有一定参考价值的客观依据。方法:采用随机平行对照研究方法将63例肾气不足、肾阳亏虚型DNB患者按随机数字表法随机分为治疗组和对照组,两组患者均予个体化基础治疗(糖尿病相关知识宣教,糖尿病饮食、运动指导,药物控制血糖、血脂等),对照组予口服甲钴胺片(弥可保)0.5mg/次,每日3次;治疗组在此基础上予温灸盒温灸治疗,疗程4周。观察患者治疗前后的膀胱残余尿量、中医证候积分、美国泌尿科协会症状指数积分、HbA1c等指标的变化情况,并对试验过程中呈现出的不良反应作好相关记录。结果:1、膀胱残余尿量:两组患者治疗后的膀胱残余尿量与治疗前比较,均得到有效减少(P0.01),两组间治疗后膀胱残余尿量比较,治疗组的治疗效果明显比对照组更好(P0.01),提示温灸盒温灸联合甲钴胺治疗在减少膀胱残余尿量方面有较好疗效。2、中医证候积分:临床研究提示,治疗后两组DNB患者的症状均有改善(P0.01),对两组间治疗后中医证候积分进行比较,治疗组证候积分的减少程度比对照组鲜明(P0.05),提示温灸盒温灸联合甲钴胺治疗在改善中医症状方面有疗效较好。3、美国泌尿科协会症状指数积分:治疗后两组DNB病患的排尿症状指数积分与治疗前比较,均有降低(P0.01),但治疗组的治疗效果比对照组更好(P0.01),提示温灸盒温灸联合甲钴胺治疗具有改善下尿路症状的作用。4、糖化血红蛋白:两组患者治疗后HbA1c较治疗前均有下降(P0.01),但两组间比较无明显差异(P0.05),提示基础治疗使血糖达标后,温灸及甲钴胺治疗对血糖的控制无明显影响。5、安全性分析:研究观察过程中,所纳入研究的患者在治疗前、后各项安全性指标检查结果均未出现明显异常,治疗过程中均未发生严峻不良反应。结论:温灸盒温灸联合甲钴胺对肾气不足、肾阳亏虚型DNB的治疗效果优于单纯使用甲钴胺治疗,具有减少患者膀胱残余尿量、改善中医临床症状、下尿路症状的作用,且方法简便,安全性好,无明显不良反应,价格低廉,能带来一定的社会经济效益,值得临床更深入的研究。
[Abstract]:Objective: to evaluate the clinical efficacy and safety of warm moxibustion box in the treatment of diabetic neurogenic bladder (deficiency of kidney qi and deficiency of kidney yang). Methods: 63 DNB patients with deficiency of kidney qi and deficiency of kidney yang were randomly divided into treatment group and control group according to random digital table. Patients in both groups were given individualized basic treatment (diabetes related knowledge education, diabetes diet, exercise guidance, drug control of blood sugar, blood lipid, etc.) the control group was given oral mecopromazine 0.5 mg / time, 3 times a day; The treatment group was treated with warm moxibustion box with warm moxibustion for 4 weeks. The changes of bladder residual urine volume, TCM syndromes score and HbA1c index of the American Urology Association were observed before and after treatment. Results: the residual urinary volume of the two groups after treatment was significantly reduced compared with that before treatment, and the residual urinary volume of the two groups was compared with that of before treatment, and the residual urinary volume of the two groups after treatment was compared with that of the control group, and there was no significant difference in the residual urinary volume between the two groups. The therapeutic effect of the treatment group was obviously better than that of the control group, indicating that the warm moxibustion box combined with mecobalamin had a better curative effect on reducing the residual urinary volume of the bladder. After treatment, the symptoms of DNB patients in both groups were improved (P 0.01). The scores of TCM syndromes after treatment were compared between the two groups. The decrease of syndromes in the treatment group was higher than that in the control group (P 0.05), suggesting that the warm moxibustion box combined with mecobalamin had a better effect on improving the symptoms of traditional Chinese medicine. The American Urology Association symptom Index integral: after treatment, the two groups of DNB patients were treated with mild moxibustion box and mecobalamin. To compare the score of urinary symptom index with that before treatment, The results showed that the treatment of warm moxibustion box combined with mecobalamin could improve the symptoms of lower urinary tract. 4. Glycosylated hemoglobin: after treatment, HbA1c in both groups was lower than that before treatment. However, there was no significant difference between the two groups (P 0.05), suggesting that the basic treatment could make the blood sugar standard, but there was no significant difference between the two groups. Warm moxibustion and mecobalamin treatment had no significant effect on blood glucose control. Safety analysis: during the course of study, the safety indexes of the patients included in the study were not abnormal before and after treatment. Conclusion: the effect of warm moxibustion box combined with mecobalamin on renal qi deficiency and deficiency of kidney-yang type DNB is better than that of mecobalamin alone, and it can reduce the residual urine volume of bladder. It can improve the clinical symptoms of traditional Chinese medicine and lower urinary tract symptoms, and the method is simple, safe, no obvious adverse reactions, low price, can bring certain social and economic benefits, and is worthy of further clinical research.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R246

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